Medicare Part C, commonly called Medicare Advantage, costs most enrollees around $14 per month in plan premiums for 2026. But that number doesn’t tell the full story. You’re also required to keep paying your Part B premium, which brings the baseline monthly cost to at least $216.90 for most people. On top of that, copayments, deductibles, and coinsurance vary widely depending on which plan you choose and where you live.
The Two Premiums You’ll Pay
Medicare Advantage has a cost structure that trips up a lot of people: you don’t just pay one premium. To enroll in any Part C plan, you must have Medicare Part B and continue paying that premium every month. In 2026, the standard Part B premium is $202.90. That’s a $17.90 increase from 2025. If your income is higher (roughly 8% of Part B enrollees fall into this category), your Part B premium will be adjusted upward based on tax returns from two years prior.
On top of Part B, most Medicare Advantage plans charge their own monthly premium. The national average across all enrollees is $14.00 per month in 2026, but many plans charge $0. These $0-premium plans are widely available in most parts of the country, which is one of the main reasons people switch from Original Medicare to Medicare Advantage. Keep in mind that a $0 plan premium doesn’t mean $0 total cost. You still owe the $202.90 Part B premium regardless.
How the Part B Giveback Benefit Works
Some Medicare Advantage plans actually reduce your Part B premium through what’s known as a “giveback” benefit. These plans use a portion of their government funding to cover part or all of your $202.90 monthly Part B cost. The reduction gets applied automatically to your Social Security check.
The amounts vary significantly. Among plans that offer a giveback, 36% provide a monthly reduction of $100 or more, 23% offer between $50.01 and $100, and 28% offer $10 or less. Whether a giveback plan is available to you depends entirely on your zip code and the plans offered in your area. A generous giveback can bring your effective monthly premium well below what you’d pay on Original Medicare alone.
Deductibles and Out-of-Pocket Costs
Beyond premiums, what you actually spend on Medicare Advantage depends on how often you use care and what services you need. Most plans charge copayments for doctor visits, with primary care visits typically costing less than specialist visits. Emergency room copayments tend to be higher, though they’re usually waived if you’re admitted to the hospital.
If your plan includes prescription drug coverage (most do), federal rules cap the drug deductible at $615 per year in 2026. Many plans set their drug deductible lower than that, and some eliminate it entirely. After the deductible, you’ll pay copayments or coinsurance for each prescription, with costs varying by the drug’s tier. Generic medications cost the least, while specialty drugs cost the most.
Every Medicare Advantage plan is required to cap your total out-of-pocket spending on covered services each year. This is one of the key financial protections that Original Medicare doesn’t offer. Once you hit that cap, the plan covers 100% of your in-network costs for the rest of the year.
HMO vs. PPO Plan Costs
The two most common types of Medicare Advantage plans are HMOs and PPOs, and they handle costs differently in one critical way: what happens when you see a doctor outside the plan’s network.
With an HMO, you generally can’t use out-of-network providers except in emergencies. If you do, you’ll pay 100% of the cost yourself. HMO premiums tend to be lower because of this restriction. PPO plans give you more flexibility to see out-of-network doctors, but you’ll pay higher copayments or coinsurance for doing so. Both plan types cover in-network care at the same general cost-sharing levels, so if you’re comfortable staying within a network, an HMO can be the cheaper option. If you travel frequently, split time between two locations, or want the freedom to see specialists without referrals, a PPO may be worth the higher cost.
Help Paying for Drug Costs
If you have limited income, the federal Extra Help program can significantly reduce what you pay for prescriptions under your Medicare Advantage plan. In 2026, you may qualify if your annual income is below $23,940 as an individual or $32,460 as a married couple. Your countable resources (savings, investments, real estate other than your home) must also fall below $18,090 for individuals or $36,100 for couples.
Extra Help covers most or all of your drug plan premium, deductible, and copayments. You can apply through Social Security’s website or by calling your local Social Security office. Many people who qualify never apply because they don’t realize the program exists.
Why Costs Vary So Much by Location
Medicare Advantage pricing isn’t set nationally. The government pays plans a fixed amount per enrollee based on the county you live in, adjusted for your health status. In areas where that payment is generous relative to local healthcare costs, plans can offer richer benefits, lower premiums, and giveback programs. In areas where the payment is tighter, plans may charge higher premiums or have steeper copayments.
This is why two people in different states can have dramatically different experiences with Medicare Advantage costs. Someone in South Florida might have dozens of $0-premium plans with dental and vision coverage included, while someone in rural Montana might see fewer options with higher out-of-pocket costs. The only way to know your actual costs is to compare plans available at your specific zip code through Medicare’s plan finder tool during open enrollment.